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New Treatment Recommendations for Systemic Juvenile Arthritis

Guidelines based on more than 1,200 clinical scenarios (September 24)

In the U.S., nearly 300,000 children have juvenile arthritis and other rheumatic illnesses, according to estimates from the American College of Rheumatology (ACR).

New treatment recommendations for children with systemic juvenile idiopathic arthritis (JIA) have been published in two ACR journals, Arthritis & Rheumatism and Arthritis Care & Research.

Systemic JIA is defined by the International League of Associations for Rheumatology as arthritis in one or more joints for at least 6 weeks in children 16 years of age or younger. The arthritis is accompanied or preceded by fever for at least 2 weeks that is daily for at least 3 of those days, with one or more of the following symptoms: evanescent erythematous rash; enlarged liver, spleen, or lymph nodes; and serositis of the lungs, heart, or stomach. Medical evidence suggests that systemic JIA accounts for 4% to 15% of all JIA cases.

The new recommendations for systemic JIA are based on more than 1,200 clinical scenarios and include recommendations for use of the following medications:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Glucocorticoids
  • Methotrexate
  • Leflunomide
  • Intravenous immunoglobulin (IVIG)
  • Calcineurin inhibitors
  • Tumor necrosis factor-alpha (TNF-alpha) inhibitors
  • Abatacept
  • Rituximab
  • Anakinra
  • Canakinumab
  • Rilonacept
  • Tocilizumab

The new guidelines include treatment options for patients with and without active systemic disease, along with varying degrees of synovitis, as well as recommendations for repeat tuberculosis screening for JIA patients receiving biologics.

Source: Wiley; September 24, 2013.

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